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z~ <br />~-~~ .. II I I II I II I II IIII III ~ gl " <br />• REGULAR (112) PERMIT APPLICATION FORPf ' <br />STATE OF COLORADO ~. Application for Mining, and <br />Hired Land Reclamation Board ' + ) Reclamation Permit, Pursuant <br />De artment of Natural Resources ~'~~' ""`"'' 1""7`' __ <br />P to C.R.S. 1973 34-32-101 et sc <br />1313 Sherman Street, Room 723 <br />Denver, CO 80203 N OV 1 ~~~) <br />~ 1. Name of operations `~~~' <br />(Pit, mine, or site name) <br />i <br />2. Name of applicant/operator <br />(Name to be used on permit) <br />3. Address and phone number of <br />local offices <br />4. Address and phone number <br />of general offices <br />--~r~ --- <br />--- <br />;_ ~ti¢~t=Amick Pit <br />Darryl Stout <br />5. Name end phone number of person <br />staff members should contact <br />6. Parent Corporation, if any <br />(Include name b address) <br />7. Owner(s) of record of affected <br />land (surface area) <br />(If more than 2, list in Ext+ibtt P) <br />8. Owner(s) of substance to he mined <br />(If more than 2, list in Exhihi[ P) <br />9. Source of legal right to enter <br />(Indicate what type of proof is <br />included in Exhibit 0 - lease, decd, <br />notarized letter, etc.) <br />R7R-5371 - <br />Same <br />Jack H. Raley R7R-5601 <br />None <br />_ Phy_llis_Amick <br />-?~~iS_~4k - <br />Deed <br />10. Tyae of mine 6 substance to be mined Open Gravel Pit <br />(Specify underground, strip, open pit, - ------ - - - - - '- - - <br />etc. and substance(s) to be mined) ---------- ------ <br />11. General location b elevation (Miles 5 Mi SE of Meeker <br />6 direction from nearest town d <br />approximate site elevation) Elev 6600_ ±______ <br />12. County <br />13. Acreage of affected lands <br />(Total surface acreage to be <br />included in permit) <br />--~ _--Stir ~lanco___-- <br />42,R Acres <br />14. Application fee (See Rule 2 to <br />determine amount) <br />15. Present land use <br />(i.e., agricultural, industrial, etc.) <br />16. Surrounding land uses <br />17. Proposed future land use <br />(Goal of reclamation) <br />$695,00 <br />Dry land pasture _ _ <br />--A4T.iS+L1~S1Sd1. -__--- <br />_ Rangeland ___ <br />18. Other mining permits b operations None <br />in Colorado (See Rule 2 for guidance) - -- <br />19. The lands herein do not affect any of Th_ey__d_o_ not. <br />the lands described in Section <br />1.56(9), (Specify affirmation) _ __ _ - _- <br />